In vivo confocal microscopy:qualitative investigation of the conjunctival and corneal surface in open-angle glaucomatous patients undergoing the XEN-Gel implant,trabeculectomy or medical therapy  

作　　者：Stefano Baiocchi Cosimo Mazzotta Arianna Sgheri Alessandro Di Maggio Simone Alex Bagaglia Matteo Posarelli Leonardo Ciompi Alessandro Meduri Gian Marco Tosi 

机构地区：[1]Department of Medicine,Surgery and Neurosciences,Ophthalmology Unit,Policlinico Santa Maria alle Scotte,University of Siena,Viale Bracci 8,ZIP code 53100 Siena,Italy [2]Ophthalmology Unit,Department of Biomedical Sciences,University of Messina,Messina,Italy

出　　处：《Eye and Vision》2022年第1期19-32,共14页眼视光学杂志（英文）

摘　　要：Purpose:Assessing the quality of the ocular surface by in vivo scanning laser confocal microscopy(IVCM)in primary open-angle glaucoma(POAG)patients treated by XEN 45 Gel Stent,medical therapy and trabeculectomy.Methods:Retrospective,single-center,single-masked,comparative study including 60 eyes of 30 patients(mean age 61.16±10 years)affected by POAG.Eyes were divided into 3 groups:Group 1 eyes underwent the XEN 45 Gel Stent procedure,Group 2 eyes^were under medical therapy,Group 3 eyes were surgically treated by trabeculectomy.All patients underwent HRTII IVCM analysis of cornea,limbus,conjunctiva,sub-tenionian space and sclera.Results:The XEN 45 Gel Stent,if properly positioned in the sub-conjunctival space preserves goblet cells and limits ocular surface inflammation.Regular corneal epithelial cells with microcysts,and normo-reflective sub-epithelial nerve plexus are documented by IVCM.In sub Tenon's implants an alternative lamellar intra-scleral filtration is detectable.Combined surgical procedures show a noticeable number of inflammatory cells with rare microcysts.Post-trabeculectomy inflammatory reaction is more evident than XEN 45 Gel Stent associated surgical procedures,but less than medical therapy where a conspicuous presence of Langerhans cells,peri-neural infiltrates,marked loss of goblet cells and fibrosis is visible.Conclusion:Ocular surface inflammation was more notable in topical therapy than after trabeculectomy,which itself causes more inflammation than XEN Gel Stents.

关 键 词：Glaucoma Primary open-angle glaucoma POAG MIGS XEN 45 Gel Stent Ocular surface Inflammation Confocal 

分 类 号：R775[医药卫生—眼科]